在共同决策过程中,重症监护室的家庭成员和医生之间的对话:一种定性观察研究
Qing Lu1, Juan Ji2, Xiao-Yan Lu1
1Department of Intensive Care Unit, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
Journal of multidisciplinary healthcare
|August 6, 2025
概括
在重症监护中,医生和家人的共同决策是有限的,特别是在生命末期的情况下. 这可能无法完全捕捉患者的价值观,导致家庭痛苦.
科学领域:
- 医学伦理 医学伦理
- 临床交流 临床沟通
- 患者家庭为中心的护理.
背景情况:
- 了解医生与家庭之间的沟通对于有效的共同决策至关重要.
- 在重症监护室 (ICU) 中的重症患者往往缺乏决策能力,需要家庭参与.
研究的目的:
- 分析医生与重症患者家属之间的决策对话的动态.
- 评估ICU中共享决策的程度和上下文依赖性.
主要方法:
- 定性观察性研究涉及音频记录40个医生-家庭对话在一个ICU.
- 在住院,病情变化和生命末期护理期间的决策过程的诱导性内容分析.
主要成果:
- 信息共享发生在决策的所有阶段,但程度因环境而异.
- 共享决策特别低,特别是在终生情景中.
- 家庭参与终身决策可能仅反映家庭偏好,不一定反映患者的偏好.
结论:
- 在ICU中,医生和家庭之间的共同决策是有限的,并且取决于背景.
- 终身决策主要涉及家庭,可能会误解患者的价值观.
- 家庭经历了重大决策困难和遗憾,突出需要更好的支持.
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